Pneumonia in the child

Definition

Pneumonia, which is also called pneumonia in the technical language, is an inflammation of different parts of the lung. It is the most common respiratory disease in children and can be caused by various pathogens such as bacteria or viruses. It should be noted that the symptoms in children can be very unspecific. As pneumonia can under certain circumstances even lead to death, a (paediatric) doctor should be consulted in good time and in a timely manner. Pneumonia can be diagnosed by listening with a stethoscope, an x-ray or with the help of a blood test / blood culture by cultivating pathogens.

Causes

Pneumonia is an infectious disease. This means that the disease is caused by germs that attack the lungs. These can be bacteria as well as viruses or fungi.

The most common pathogens that cause pneumonia in children are pneumococci. Other common bacteria, which mainly affect school children, are mycoplasma and chlamydia. Common viruses that cause pneumonia in children are RS viruses, rhinoviruses and parainfluenza viruses.

If bacteria are the cause of pneumonia, it is called typical pneumonia, while atypical pneumonia is often caused by viruses. However, pneumonia is often caused by several germs together. Hospital-acquired pneumonia (nosocomial pneumonia) is caused by different bacteria than outpatient-acquired pneumonia, as it is rather rare.

This includes, for example, the germ Pseudomonas. This is particularly dangerous for children with immune defects or diseases affecting the lungs, such as cystic fibrosis. Risk factors for a child getting pneumonia are, in addition to serious pre-existing heart or lung diseases, also diseases in which the immune system is weakened.

The diagnosis of pneumonia can sometimes not be so easy. Many symptoms are not particularly specific, especially in children, so that pneumonia can also go undetected. When examining the lungs with a stethoscope, so-called rales may be heard, indicating that the lungs are occupied.

However, this finding is very unspecific and often missing. In children, signs can be seen which indicate that breathing is difficult. These include nasal wings (movement of the nasal wings when breathing) or great effort when breathing in.

When inspecting (looking at) the upper body, retractions of the ribs may be visible. During a blood examination, inflammation values such as the BSG (blood sedimentation rate), the CRP (C-reactive protein) and the procalcitonin may be elevated. Blood cultures (to cultivate pathogens) can be taken or an examination of the sputum can be performed to detect germs.

The color of the sputum can be yellowish to green in case of bacterial infestation. Finally, an x-ray of the thorax can show that the lung is covered with infiltrates. This can be seen in the X-ray image as a so-called shadowing. Although the preparation of an X-ray is not part of routine diagnostics, it is necessary in some cases. In children under 5 years of age or with a fever above 39 °C without a definite cause, an X-ray examination is obligatory (mandatory).